An Open-Label, Balanced, Randomized, Two-Treatment, Two-Period, Two-Sequence, Single-dose Crossover Pilot Oral Bioequivalence Study of Ritonavir Capsules 100 mg with NORVIR® Ritonavir Capsules Soft Gelatin 100 mg of Abbott Laboratories, USA in Healthy, Adult, Male, Human Subjects Under Fasting Conditions
Abstract:
Background: The present
study was conducted to investigate the bioequivalence of Ritonavir Capsules 100
mg with that of Norvir® Ritonavir Capsules Soft Gelatin 100 mg.
Patients and methods: This study was
an open-label, balanced,
randomized, two-treatment, two-period, two-sequence, single dose crossover pilot
oral bioequivalence study. Study was conducted in 12 healthy, adult male subjects
with age ranging from 18 to 45 years. The total duration (excluding screening) of
subject participation in a study was approximately 11 days including washout period
of 07 days between each dosing. The estimation of Ritonavir in human plasma is carried
out by using LC/MS/MS method in Bioanalytical laboratory. The pharmacokinetic parameters
assessed were AUC0-t,
AUC0-∞, Cmax, AUC0-t/AUC0-∞, Tmax,
kel and t½.
Results: The geometric
mean ratios (90% confidence intervals) of the test drug/reference drug for Ritonavir
were 100.8 (83.64-121.51) for AUC0-t, 102.1 (85.39-122.01) for AUC0-inf,
and 97.5 (81.19-117.08) for Cmax. The 90% confidence intervals of the
test/reference AUC0-t, AUC0-∞, Cmax ratio of Ritonavir
were within the acceptance range for bioequivalence. In this study, single dose
of Ritonavir 100 mg capsule was well tolerated by both groups of subjects under
fasting conditions.
Conclusion: It was concluded
that the two Ritonavir capsules formulations (the test and reference products) were
bioequivalent in terms of the rate and extent of absorption.
References:
[1]. Hsu A, Granneman G R, Witt G, Locke C, Denissen
J, Molla A, Valdes J, Smith J, Erdman K, Lyons N, Niu P, Decourt J P,
Fourtillan J B, Girault J and Leonard. J M, Multiple-dose pharmacokinetics of
ritonavir in human immunodeficiency virus-infected subjects. Antimicrob. Agents
Chemother. May 1997 vol. 41 no. 5 898-905.
[2]. C.E. Klein, Y-L. Chiu, J. Li, R. Rode, B.
Bernstein, G.J. Hanna. Ritonavir Pharmacokinetics in Subjects 60 Years or
Older. 11th European AIDS Conference in Madr id, Spain, 24–27 October 2007.
[3]. Dale J. Kempf, Hing L. Sham, et al. Discovery
of Ritonavir, a Potent Inhibitor of HIV Protease with High Oral Bioavailability
and Clinical Efficacy. J. Med. Chem., 1998, 41 (4), pp 602–617.
[4]. Hsu A, Granneman GR, Bertz RJ. Ritonavir.
Clinical pharmacokinetics and interactions with other anti-HIV agents. Clin
Pharmacokinet. 1998 Oct; 35(4):275-91.
[5]. ICH Harmonized Tripartite Guideline;
Guideline for Good Clinical Practice; E6 (R1); Current step 4 version dated 10
June 1996.
[6]. J Ng, CE Klein, SJ Causemaker, J Xiong, YL
Chiu, K Wikstrom, TT Doan, TJ Podsadecki, B Bernstein. A Comparison of the
Single Dose Bioavailability of a Ritonavir Tablet Formulation Relative to the
Ritonavir Soft Gelatin Capsule in Healthy Adult Subjects. XVII International
AIDS Conference, Mexico City, 3‑8 August 2008.
[7]. Lledó-García R, Nácher A, Prats-García L,
Casabó VG, Merino-Sanjuán M. Bioavailability and pharmacokinetic model for ritonavir
in the rat. J Pharm Sci. 2007 Mar; 96(3):633-43.
[8]. Prescribing information – NORVIR. Retrieved
from http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=13b059c6-0c6c-49a5-b985-a4b05caf9ac9.
[9]. Prescribing information – Ritonavir.
Retrieved from http://www.rxlist.com/cgi/generic/ritonavirsol.html.
[10]. Sven A. Danner, M.D., Andrew Carr, et al., A
Short-Term Study of the Safety, Pharmacokinetics, and Efficacy of Ritonavir, an
Inhibitor of HIV-1 Protease. N Engl J Med 1995; 333:1528-1534December 7, 1995.